Life under Threat, Further Worsened by Treatment Bills

Victims of crime in the city of Padang bear a double burden. Not only are they injured or their lives threatened, they also suffer from a lack of health protection.

KOMPAS/YOLA SASTRA

Rehan Kurnia (17), a victim of crime, resting on the porch of the house with his father and mother in Kalumbuk Village, Kuranji District, Padang, West Sumatra, Wednesday (3/3/2021). Rehan\'s family still owes tens of millions of rupiah in hospital bills because victims of crime are not covered by BPJS Kesehatan.

Rehan Kurnia, 17, occasionally grimaced in pain. Dozens of stitches were scattered on the body of the X grade student of state vocational school SMK 1 Padang, West Sumatra, starting from the back of the head near the ears, shoulders, waist, to the fingers. His left hand which was covered in a dark blue cloth clasped to his chest. The ring finger and middle finger were gone. The wound started to dry up.

"Sometimes it still hurts, especially during the night," said Rehan at his house, Simpang Rambutan, Kalumbuk village, Kuranji subdistrict, Padang, Wednesday (3/3/2021). The wooden house on stilts stands on a plot of land measuring 8 meters x 12 meters.

Rehan almost lost his life in the wee hours on Feb. 7, 2021. At around 03:00 a.m., the student majoring in electrical engineering drove a motorcycle with his friend on Jalan Bypass, Kalumbuk village. They intended to buy fried rice.

Unfortunately, when they arrived on the road near the Kuranji district office, about 2 kilometers from Rehan\'s house, dozens of young men armed with sharp weapons attacked them. The sharp weapons slashed Rehand’s body. Two fingers lost when he protected the head with his hands.

Sometimes it still hurts, especially during the night.

Rehan\'s friend was lucky because he was able to run and asked the residents for help. When the residents arrived at the location, Rehan was lying and seriously injured. They took Rehan to Dr M Djamil Padang hospital.

His life was saved. Rehan underwent two operations. He got a transfusion of 10 bags of blood to replace the lost blood. The fourth child of eight children from the couple Arma Zakri, 51, and Eli Afrida, 47, underwent treatment for two weeks and three days.

The wounds that began to dry out did not necessarily dry up the grief of Rehan and his family. This economically disadvantaged family does not know how to pay the Rp 51 million hospital bill.

KOMPAS/YOLA SASTRA

The motorbike ridden by Rehan Kurnia (17) when he was a victim of crime on the Bypass Street, Kalumbuk Village, Kuranji District, Padang, West Sumatra, Wednesday (3/3/2021).

The cost of Rehan\'s surgery and treatment was not covered by Health Care and Social Security Agency (BPJS Kesehatan) even though he is registered in the government\'s National Health Insurance Card (JKN-KIS) program.

"I am really confused. At a time when the child\'s life is in danger of being lost, it is worsened by the burden of hospital costs. What does it mean that we join BPJS Kesehatan?" asked Arma Zakri, Rehan\'s father.

Rehan\'s discharge from the hospital was delayed by two days. He could go home after a guarantee of Rp 10 million from Baznas Padang, Rp 200,000 from his family, motorbike ownership document, and Eli Afrida\'s original ID card, as well as a debt statement.

I am really confused. At a time when the child\'s life is in danger of being lost, it is worsened by the burden of hospital costs. What does it mean that we join BPJS Kesehatan?

Arma is still confused about finding a way to pay off the remaining debt of Rp 41 million with a deadline of May 24, 2021. Let alone paying the debt, for daily expenses alone, he is still having trouble. The daily income of this casual worker is only Rp 70,000-Rp 100,000. Rehan\'s family can only hope for the donation of kindhearted people.

Later, Rehan\'s family planned to send a proposal to the Witness and Victim Protection Agency (LPSK). So far, they did not know that the medical expenses for crime victims can be borne by the LPSK.

Dead victim

A similar incident and burden were experienced by Yudha, 16, and his family in Pisang village, Pauh district, Padang. Unfortunately, Yudha\'s life was lost in the incident.

On May 17, 2020, after sahur (predawn meal) time during the fasting month, he was attacked and wounded by six motorcycle gang members. Yudha was taken to Dr M Djamil Padang hospital, but died five days later.

Not only covered in grief, the pair of Iril, 60, and Teti, 43, were also burdened with debt. Iril is only a laborer doing odd jobs, while Teti is a worker for washing and ironing clothes.

Their government-assisted JKN-KIS card was not applicable. The family also did not know that the LPSK could bear medical costs if they sent a request for assistance.

The total hospital bill for Yudha\'s treatment and care was Rp 77 million. Fortunately, some of them have been paid in installments with the help of Baznas, the Hamasah Insani Peduli Foundation, and other donors. The remaining debt is around Rp 40 million.

KOMPAS/YOLA SASTRA

Dr M Djamil Hospital, Padang, West Sumatra, on Sunday (10/11/2019).

Dr M. Djamil Hospital Information and Documentation Officer, Gustafianof, said that Rehan was treated as a general patient. For the reason, that is the authority of BPJS Kesehatan. To be sure, the hospital had provided services until the patient recovered.

"With regard to the costs, the patient has already returned home. According to government hospital procedures, of course there must be a debt statement. A number of families are able to pay in installments each month, there is no element of compulsion. The patient\'s family can go into debt if there is no money,” said Gustafianof.

Head of BPJS Kesehatan Padang Branch Rizka Adhiati said the costs of medical treatment and care for patients who are victims of crime are not covered by the JKN-KIS program. This is in accordance with Presidential Regulation Number 82 of 2018 on Health Insurance. "In Presidential Decree No. 82/2018, there are types of services that the JKN program does not guarantee, including victims of violence crime," said Rizka.

The head of LPSK, Hasto Atmojo Suroyo, advised Rehan and Yudha\'s families to submit requests. However, he did not promise that the requests could be granted. The final decision is discussed at the leadership level to examine the form of the case.

In Presidential Decree No. 82/2018, there are types of services that the JKN program does not guarantee, including victims of violence crime.

According to him, in providing medical assistance to victims of crime, his party considers many things. On the other hand, LPSK is overwhelmed by the burden which was previously borne by BPJS Kesehatan.

"We are overwhelmed because of the small budget. What we bear this throughout Indonesia. We have protested many times (regarding this policy). This should be the responsibility of BPJS Kesehatan," said Hasto.

An Ekasakti University health law observer, Firdaus Diezo, was of the opinion that the existence of Presidential Decree No. 28/2018 actually has a good purpose, namely to eliminate the dual financing gap. Nowadays, the costs for patients who are victims of crime are indeed borne by the LPSK.

However, Diezo said, LPSK\'s limited budget, request-based financing mechanisms, and the lack of public knowledge about the institution have the potential to lead to a vacuum in health protection for victims of crime.

This article was translated by Hyginus Hardoyo.